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Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis.

Chen M, Wei S, Hu J, Quan S - PLoS ONE (2015)

Bottom Line: A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24).The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Reproductive Centre, Nanfang Hospital, Southern Medical University, Guangzhou, China.

ABSTRACT

Objective: To examine whether comprehensive chromosome screening (CCS) for preimplantation genetic screening (PGS) has an effect on improving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes compared to traditional morphological methods.

Methods: A literature search was conducted in PubMed, EMBASE, CNKI and ClinicalTrials.gov up to May 2015. Two reviewers independently evaluated titles and abstracts, extracted data and assessed quality. We included studies that compared the IVF/ICSI outcomes of CCS-based embryo selection with those of the traditional morphological method. Relative risk (RR) values with corresponding 95% confidence intervals (CIs) were calculated in RevMan 5.3, and subgroup analysis and Begg's test were used to assess heterogeneity and potential publication bias, respectively.

Results: Four RCTs and seven cohort studies were included. A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24). CCS-based PGS was also related to an increased clinical pregnancy rate (RCT RR 1.26, 95% CI 0.83-1.93; cohort study RR 1.48, 95% CI 1.20-1.83), an increased ongoing pregnancy rate (RCT RR 1.31, 95% CI 0.64-2.66; cohort study RR 1.61, 95% CI 1.30-2.00), and an increased live birth rate (RCT RR 1.26, 95% CI 1.05-1.50; cohort study RR 1.35, 95% CI 0.85-2.13) as well as a decreased miscarriage rate (RCT RR 0.53, 95% CI 0.24-1.15; cohort study RR 0.31, 95% CI 0.21-0.46) and a decreased multiple pregnancy rate (RCT RR 0.02, 95% CI 0.00-0.26; cohort study RR 0.19, 95% CI 0.07-0.51). The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.

Conclusions: The effectiveness of CCS-based PGS is comparable to that of traditional morphological methods, with better outcomes for women receiving IVF/ICSI technology. The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

No MeSH data available.


Related in: MedlinePlus

Forest plots showing the results of meta-analysis on miscarriage comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.(a) Forest plot of pooled RR on miscarriage of RCTs; (b) Forest plot of pooled RR on miscarriage of cohort studies.
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pone.0140779.g006: Forest plots showing the results of meta-analysis on miscarriage comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.(a) Forest plot of pooled RR on miscarriage of RCTs; (b) Forest plot of pooled RR on miscarriage of cohort studies.

Mentions: Two RCTs [35, 32] and 5 cohort [29–31, 37, 34] studies evaluated the outcome of miscarriage between the CCS group and the control group. The pooled outcome from 2 RCTs (n = 192) showed a decreased miscarriage rate in the CCS group, but there was no significant difference between the two groups (RR 0.53, 95% CI 0.24–1.15) (Fig 6a). Nevertheless, a pooled analysis of outcome including the 5 cohort studies (n = 902) showed that the miscarriage rate was significantly lower in the CCS group (RR 0.31, 95% CI 0.21–0.46) (Fig 6b).


Can Comprehensive Chromosome Screening Technology Improve IVF/ICSI Outcomes? A Meta-Analysis.

Chen M, Wei S, Hu J, Quan S - PLoS ONE (2015)

Forest plots showing the results of meta-analysis on miscarriage comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.(a) Forest plot of pooled RR on miscarriage of RCTs; (b) Forest plot of pooled RR on miscarriage of cohort studies.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4607161&req=5

pone.0140779.g006: Forest plots showing the results of meta-analysis on miscarriage comparing the effect of CCS-based PGS and traditional morphological method after IVF/ICSI.(a) Forest plot of pooled RR on miscarriage of RCTs; (b) Forest plot of pooled RR on miscarriage of cohort studies.
Mentions: Two RCTs [35, 32] and 5 cohort [29–31, 37, 34] studies evaluated the outcome of miscarriage between the CCS group and the control group. The pooled outcome from 2 RCTs (n = 192) showed a decreased miscarriage rate in the CCS group, but there was no significant difference between the two groups (RR 0.53, 95% CI 0.24–1.15) (Fig 6a). Nevertheless, a pooled analysis of outcome including the 5 cohort studies (n = 902) showed that the miscarriage rate was significantly lower in the CCS group (RR 0.31, 95% CI 0.21–0.46) (Fig 6b).

Bottom Line: A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24).The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Reproductive Centre, Nanfang Hospital, Southern Medical University, Guangzhou, China.

ABSTRACT

Objective: To examine whether comprehensive chromosome screening (CCS) for preimplantation genetic screening (PGS) has an effect on improving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) outcomes compared to traditional morphological methods.

Methods: A literature search was conducted in PubMed, EMBASE, CNKI and ClinicalTrials.gov up to May 2015. Two reviewers independently evaluated titles and abstracts, extracted data and assessed quality. We included studies that compared the IVF/ICSI outcomes of CCS-based embryo selection with those of the traditional morphological method. Relative risk (RR) values with corresponding 95% confidence intervals (CIs) were calculated in RevMan 5.3, and subgroup analysis and Begg's test were used to assess heterogeneity and potential publication bias, respectively.

Results: Four RCTs and seven cohort studies were included. A meta-analysis of the outcomes showed that compared to morphological criteria, euploid embryos identified by CCS were more likely to be successfully implanted (RCT RR 1.32, 95% CI 1.18-1.47; cohort study RR 1.74, 95% CI 1.35-2.24). CCS-based PGS was also related to an increased clinical pregnancy rate (RCT RR 1.26, 95% CI 0.83-1.93; cohort study RR 1.48, 95% CI 1.20-1.83), an increased ongoing pregnancy rate (RCT RR 1.31, 95% CI 0.64-2.66; cohort study RR 1.61, 95% CI 1.30-2.00), and an increased live birth rate (RCT RR 1.26, 95% CI 1.05-1.50; cohort study RR 1.35, 95% CI 0.85-2.13) as well as a decreased miscarriage rate (RCT RR 0.53, 95% CI 0.24-1.15; cohort study RR 0.31, 95% CI 0.21-0.46) and a decreased multiple pregnancy rate (RCT RR 0.02, 95% CI 0.00-0.26; cohort study RR 0.19, 95% CI 0.07-0.51). The results of the subgroup analysis also showed a significantly increased implantation rate in the CCS group.

Conclusions: The effectiveness of CCS-based PGS is comparable to that of traditional morphological methods, with better outcomes for women receiving IVF/ICSI technology. The transfer of both trophectoderm-biopsied and blastomere-biopsied CCS-euploid embryos can improve the implantation rate.

No MeSH data available.


Related in: MedlinePlus